HomeMy WebLinkAboutFIRE LAKE BLK 1 LT 8A
Municipality of Anchorage
DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION POUCH 6-650
ANCHORAGE, ALASKA 99501
£ 75 . , / -
INSPECTION REPORT ON ONSITE SEWAGE DISPOSAL SYSTEM AND/OR WELL
NAME .-~ ~. ~"I~ ~,~.h~. ~,.
ADDRESS ~.~),.~)OY, ~ ~'~~
PHONE(S)
LEGAL DESCRIPTION
I PER~ NUMBE~R
SEPTIC TANK
MANUFACTURER
MATERIAL ~""\I'OP. jC'~L,..~ #OF COMPARTMENTS
INSIDE DIMENSIONI DEPTH
LENGTH /WIDTH
\OOO
CAPACITY IN GALS.
SEEPAGE SYSTEM
~ TILE DRAINFIELD
NUMBER OF LINES LENGTH EACH TOTAL LENGTH
DISTANCE BETWEEN LINES TRENCH WIDTH 5(0
'ILE TO GRADE FILL BELOW TILE FILL ABOVE TILE
~[,SEEPAGETRENCH Off [] PIT
qDTH ~J I~lt-LENGTH ~JIR DEPTH kJ/l~
~,(~ ~ [ [] LOG CRIB
[] RINGS- DIA,
FILL MATERIAL DEPTH
rOTAL EFFECTIVE ABSORPTION ARE/~: ,.'~..~O SQ, FT.
WELL
CLASSIFICATION DEPTH PIPE MATERIAL
INSTALLER
DISTANCES
SEPTIC SEEPAGE SEWER
TANK SYSTEM LINE CESSPOOL WELL
WELL ~
SYSTEM DIAGRAM
REMARKS
DAT~ APPROVED
72-012 (9/77);
LOT: ~ ~: BLOCK:
FIF'PL.. ]: CAN'T' ..:f I M ..LHF. F-. F'O. 8><.
LC ': A"r I ON F'I '.--:SH HR'T'C:H~R'T' RSD.
I...EGRt_ I_T. 8-A BK. i F IF..ELHk. E S,,"D
'T'"¢PE OF :~;f3II_. HE ..... RE, I ION S"r'STEM IS: TRENCH
MA::':: :[ MUM NUMBE:R OF EE[:'R::M'~ =
LOT S ]: ZE: ]' ':: :' 9 ':. ::.! _ ARE FEET
.... UIL. RATINC3 "~:~.' FT,.."BR',=
']"HE REQI..IIRED SIZE OF "['HE: ':-:niL HB._,(.F..PT]LN '~'-r'STE:'M IS:
]'HE LENGTH DIMENSION IS THE I.ENGTH (IN FEET) {_.:iF THE TRENCH OR [>RRINFIEI._D.
]"HE DEPTH OF FI TRENCH OF,' PIT I'_g THE DISTANCE BETWEEN THE SLIF.!FRCE OF THE:
GROUND AN[:." "['HE BOTTOM OF THE E',:.(CA'v'ATION (IN FEET::,.
]"HERE IS NO SET WIDTH FOR 'FRENCHES.
]"HE GRAVEL DEPTH IS THE MINIMUM DEPTH OF GRAVEL BETWEEN THE OLrTFALL. PIPE
AND ]"HE BOT'T'OM OF THE EXCAVATION (IN PEET'.:,.
F" R I'_': I.-(.: R i_--'_-i F..:" F" L. R I'-~ -F [:, F' ]- I mira FI
PRCKAGE PLRNT MAY BE INSTALLED AT THE.PERMITTEE'S OPTION SUBJEC'I" 'to THE:
FOI...LOW I NG CON[:, I T IONS:
:1.. EITHER A CLASS I OR I I NSF' APPROVED PLANT MR"[' BE INSTAl_LED.
2.'. R CONTINUOUS MAINTENANCE AGREEMENT IS REQUIRED. IF' A MAINTENANCE
AGREEMENT IS; NOT KEPT CURRENT "r'OU MA'T' BE REQUIRED TO ENLARGE 7'HE SOIl..
ABSORPTION S"r'STEM AND,.'"OR "r'OU MR"[' BE SUBJECT TO PROSECUTION
.... r [.1 ~::~ .:: :--?. ::. I Ii _~:3 F' E: C: T I C~ r-I _~.; R F-: El R E L:! I_1 I R E I::. ........
'-'~ ".'--; " ' "' '" E:'T'
BACKFILLING OF tiNY =,~_TEM WITHCIUT FINAL INSF'ECTION AND HPFI~_ HI_ THIS
[:,EF'RR. TMENT WILL BE SIJBJECT TO F'ROSECLI-r ION.
MINIMUM DISTANCE BETWEEN A WELL AND ANY ON-SITE SEWAGE DISPOSAL S¥'.E;TE:M IS
:I.E~C.~ FEET FOR R PRIVATE WE[_[.. OR 2'OF~ FEET FOR A F'UBLIC WELl._
WELL. LOGS ARE: REQUIRED AN[) MUST BE RETURNED TO THE DEPARTMENT WITHIN 2::E~ [.',A'¢S
OF 'THE WE[_[.. C:OMPLETION.
OTHER REQUIREMENTS MAY FtPPL¥. SPECIFICATIONS AND CONSTRUCTION [:,IAGRAM'E; ARE
A',,,'R i LABLE TO INSURE PROPER INSTFILLATION.
I C':ER'T I F'¥ 'T'HA]"
:1.: I RM FFIMIL]:AR WITH THE REQIJIREMENTS FOR ON-SIT'E SEWERS fiND WEL. I...S RS SET
I='OR]"H B'T' THE D1LINICIPALIT¥ (DF ANCHORAGE.
2: I WIL. L INS]'ALI.. "FHE SYSTEM ]:[4 ACCOR[:,ANC:E WITH ]'HE CODES.
ii:: I UNDERS]"AND 'T'HAT TFIE ON-SITE SEWER S'.r'STEM r,tFt¥ REE).UIRE ENL. FIRGEMENT IF: THE
RE::.::;IDENCE IE; REMODEL.ED TO INCLU[:,E: MORE TFIRN :2; E:E[:,ROOMS.
flPF'I_ I CRN]" JIM CLARK
O 8- E GEO'
Russell Oyster
694-2774
Soils ~' Foundations
Perfomed for:
,=HNICAL 8- DEVEL
Box 90, Davis St., Eagle River, Alaska 99577
694-2774 or 688-2280
SOIL LOG
Name:
Mailing Address:
Legal Description:
Depth (feet)
0
2
3
6
7
,
Z2
z3
16
Soll Characteristics
MENT
Tel. No.
CO.
Earl Ellis
688-2280
Land Development
Ground Water Encountered: Yes
Proposed Installation: Seepage Pit~
Co~ents:
No
If yes, what depth
Drain Field
Performed by: Date:
~.~ ~ -~
~ ~o ~
5(Lo £
OWNER OF LAND
ADDRESS
LEGAL DESCm~rION
by
DOC Co. dba
SULLIVAN WATER WELLS
P.O. BOX 670272, CHUGIAK, ALASKA 99567 · TELEPHONE 688.2759
DATE - Started
PERMIT NUMBER
STATIC LEVEL OF WATER Fl.
DRAW DOWN Fl-.
/
(;ALS. PER HR ~-~ (~ t.;s
KIND OF CASING
KIND OF FORMATION:
From_,'~ Ft. to ~: Ft. t--'~-"-'.~'~'~ '&~/ / C.~ From. Ft. to___Ft,
~ z~ -- ," . Ft. to Ft,
From ;;~ Ft. to ) Ft. [)0~2','< l~'~r Frmn
From ,~ .Ft. to z'~ Ft.
, , - :- _.. ~o,,,~ 2 1 1996
From/,/, Ft. to_/~.) Ft. ~"~g d'~Z~'~:'~ F~.to
- / -' 3z, Tc
From~Ft. to- ~Ft. ~/ ;._~,s,bct. ~ Frmn, Fl lo~tl Ft
.... . ~ :~_ /c~pality ut Anchorage
From//~., Ft. to/~'~ .Ft.../~,~7T .~'~d~-~ ~rmn. Ft.~pt. Hea~.&H:ma~Se~lce
From Ft. to_ ~ Ft. ~.) [~(~'~ From ~Ft. lo~Ft.
From_ Ft. to _Ft. From Ft. to_~ Fl.
From_~Ft. to~Ft,_ From Ft to_~Ft.
From_ Ft. to.~-Ft. Fromm. Ft. to__Ft.
From.~.Ft. to_~Ft. From_~Ft, to Ft
From~Ft. to_ Ft. From ~Ft. to_~Ft
From_- Ft, to_ Ft. From~Ft. to_ ~Ft.
From _Ft. to_ Ft. From.~Ft. to ~ Ft,
From~Ft. to Ft. From~ Ft. to_ Ft.
From _Ft. to Ft._ From Ft. to~Ft-
RF-CE!VED
MISCL. INFORMATION:
DRILLER'S NAME ;,, ~ " ..... --
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH AND HUMAN SERVICES
P.O. BOX 196650, 825 "L" STREET, ROOM 502
ANCHORAGE, ALASKA 99519-6650
ON-SITE WELL SYSTEM (UPGRADE) PERMIT
PERMIT NUMBER:SW950028
DESIGN ENGINEER:DUMMY COMPANY
OWNER NAME:HESTER ROBERT A & BRENDA J
OWNER ADDRESS:13724 KNOB HILL DR
PAGE 1 OF
DATE ISSUED: 3/13/95
EXPIRATION DATE: 3/13/96
PARCEL ID:05136107
LEGAL DESCRIPTION:
FIRE LAKE BLK 1 LT
8A
LOT SIZE: 38840 (SQ. FT.)
NUMBER OF BEDROOMS: 3 THIS PERMIT: 3
THIS PERMIT IS FOR THE CONTRUCTION OF:
WELL SYSTEM
ALL CONSTRUCTION MUST BE IN ACCORDANCE WITH:
1. THE ATTACHED APPROVED DESIGN.
2. ALL REQUIREMENTS SPECIFIED IN ANCHORAGE MUNICIPAL CODE CHAPTERS
15.55 AND 15.65 AND THE STATE OF ALASKA WASTEWATER DISPOSAL
REGULATIONS (18AAC72) AND DRINKING WATER REGULATIONS (18AAC80).
3. THE ENGINEER MUST NOTIFY DHHS AT LEAST 2 HOURS
PRIOR TO EACH INSPECTION. PROVIDE NOTIFICATION BY
CALLING 343-4744 ( 24 HOURS ) · (NOT REQUIRED FOR WELL ONLY PERMIT)
4. FROM OCTOBER 15 TO APRIL 15 A SUBSURFACE SOIL
ABSORPTION SYSTEM UNDER CONSTRUCTION DURING FREEZING
WEATHER MUST BE EITHER:
A. OPENED AND CLOSED ON THE SAME DAY
B. COVERED, SEALED AND HEATED TO PREVENT FREEZING
5. THE FOLLOWING SPECIAL PROVISIONS.
SPECIAL PROVISIONS
DATE
1~ hereby certify thet I have ~u~lted thl ~oUl3wing
Anchor~e ~co~inl Pr~ct. ~k~ ind ~t ~e
improvem~ s{tunied ther~n are wi~in the pro.fy
lines and do not ov~l~p or en~o~ ~ ~e pro~
lyin{ adjacent the~to, that' no imwove~ents on p~p-
erty {yin~ adjacent there~ encr~ on the ~ m
~u~tion and that there ~
{in~ ~ other visibte e~n~ on
as ~dics~ her~n.
Dated at ~{le ~ver, Al~ka
1' =)o ~x 456, ~gle
P~ne ~4-25~